| Importance of AV synchronous pacing during low intensity exercise evaluated by oxygen kinetics. | |
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MedLine Citation:
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PMID: 10709225 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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It has been shown that dual chamber pacing with preservation of AV synchrony (DDD) is superior to fixed rate ventricular (VVI) or rate responsive ventricular (VVIR) pacing modes, as evaluated by ventilatory response to exercise. Previous studies have focused on the benefits of maintained AV synchrony at maximal exercise. However, there are limited data comparing O2 kinetics in different pacing modes during low intensity exercise, representing the majority of daily activities. This study aimed to provide an evaluation of different pacing modes using O2 kinetics during low intensity exercise. Nineteen patients (age 61 +/- 18 years) with complete AV block underwent low intensity treadmill exercise (35 W) with simultaneous evaluation of symptoms and O2 kinetics in three pacing modes. The first test was performed in DDD mode followed by a second test in VVIR mode with a programmed heart rate corresponding to the sinus rate during the first test. After 6 minutes of each test, the mode was switched from DDD to VVIR and vice versa. The third test was performed in VVI mode at 70 beats/min. O2 kinetics were defined as O2 deficit (time [rest to steady state] x delta VO2-sigma VO2 [rest to steady state]) and mean response time (MRT) of oxygen consumption (O2 deficit/delta VO2). The O2 deficit was 551 +/- 134 mL in DDD pacing, 634 +/- 139 mL in VVIR pacing, and 648 +/- 179 mL in VVI pacing (P = 0.001). MRT was 49 +/- 7.8 seconds in DDD pacing, 54.7 +/- 9.5 seconds in VVIR pacing, and 57.4 +/- 11.0 seconds in VVI pacing (P = 0.002). Ten (53%) patients developed symptoms during switch from DDD to VVIR mode whereas the switch from VVIR to DDD mode was not perceived by any patient (P < 0.001). In conclusion, our study shows an impact of AV synchronous pacing and heart rate adaptation on O2 kinetics during low intensity exercise that correspond to casual daily life activities. Our observations may have clinical implications for the management of patients with complete AV block. |
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Authors:
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H Rickli; H P Brunner-La Rocca; D J Maccarter; F Duru; R Candinas |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 23 ISSN: 0147-8389 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 2000 Feb |
Date Detail:
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Created Date: 2000-03-30 Completed Date: 2000-03-30 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 174-9 Citation Subset: IM |
Affiliation:
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Division of Cardiology, University Hospital Zurich, Switzerland. mboa6@ms1.kssg.ch |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Atrioventricular Node
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physiology* Cardiac Pacing, Artificial / methods* Exercise Test / methods Female Humans Male Middle Aged Oxygen / pharmacokinetics* Oxygen Consumption* Pacemaker, Artificial* Physical Exertion* |
| Chemical | |
Reg. No./Substance:
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7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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